IVF News

16th December, 3pm EST, 8pm UK, 9pm CET

Moderators: 
Dr Pierre Comizzoli
Panelist: Matt Pettit

Presenters:
Tullis Matson FRAgS, HonDTech, DL: Life after Life
Professor Andrew Pask: Restoring the past to protect our future
Dr Andres Gambini: All in the Family: In Vitro Embryo Production in Horses, Donkeys, Mules and Zebras

Q and A

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9th December, 3pm EST, 8pm UK, 9pm CET

Moderators:
Dr Mina Alikani
Dr Başak Balaban

Presenters:

• Dr Lodovico Parmegiani: Universal post-warming dilution of
  vitrified embryos: impact of different vitrification/warming kits, warming
  volume and rapid dilution/rehydration steps on survival and clinical outcomes
• Dr Juergen Liebermann: Life in the fast lane
• Dr Ana Cobo: Comparison of one-step and conventional warming in sibling donor oocytes: a proof-of-concept study

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New clinical report challenges assumptions about embryo viability and highlights the complexity of PGT-A interpretation

The first documented birth of healthy twins following the transfer of embryos diagnosed as aneuploid has been reported, adding an important data point to the ongoing discussion about the limitations of preimplantation genetic testing for aneuploidy. The findings come from a case report published in Fertility and Sterility and summarised by EMJ Reviews. Together, they describe a scenario that underscores how embryo genetics, early developmental dynamics, and biopsy sampling can interact in unexpected ways.

The case involved a patient who underwent IVF with PGT-A. Two blastocysts were classified as aneuploid by trophectoderm biopsy. Both embryos were transferred after counselling, and both implanted. The pregnancy progressed normally, and the patient delivered healthy twins with no structural anomalies. Postnatal karyotyping confirmed that the twins were chromosomally normal.

This outcome reinforces the growing understanding that a trophectoderm biopsy represents only a small fraction of the embryo. False positive aneuploid calls can occur if the sampled cells contain mosaic or transient abnormalities that are not representative of the inner cell mass, which forms the fetus. As the field has recognised in recent years, some embryos labelled as aneuploid may still have the developmental capacity to self-correct or may have had normal ICM lineages from the start.

The authors emphasise that this report does not suggest routine transfer of embryos diagnosed as aneuploid. Instead, it highlights the need for careful counselling and the importance of ongoing research into the predictive value of PGT-A. Clinicians continue to debate how best to interpret low-level mosaicism, segmental abnormalities, and complex profiles, especially when patients have limited embryos available for transfer.

From a scientific standpoint, this case provides further evidence that embryo genetics is more nuanced than binary categories can capture. The discordance between the biopsy result and the clinical outcome underscores the importance of technical precision, biological variability, and thoughtful interpretation.

For IVF laboratories and clinicians, the report ultimately serves as a reminder that the embryo is a dynamic system. While PGT-A remains a widely used screening tool, individual outcomes like this one highlight the need for continued refinement of testing methods and more robust data to guide clinical decision-making.

Sources

18th November, 3pm EST, 8pm UK, 9pm CET
This webinar is kindly sponsored by Future Fertility

Moderators:

Dr Munevver Serdarogullari and Dr Nacho Landaburu Mari

Panelist:
Jullin Fjeldstad

Presenters:
Dr Yosu Franco Iriarte: The history of eggs
Dr Dan Nayot: Oocyte quality and stimulation protocols
Dr Daniela Braga: Can oocyte quality be an additional KPI in cases with severe male factors?

Q and A

VIEW HERE

In a recently published case report, researchers describe the first known instance of a healthy live birth following the microsurgical removal of an extra female pronucleus (PN) from a tripronuclear (3PN) human zygote derived from intracytoplasmic sperm injection (ICSI). 

Background

In conventional in-vitro fertilisation (IVF) and ICSI treatments, a normally fertilised zygote is characterised by the presence of two pronuclei (one from sperm, one from oocyte) and two polar bodies.  Zygotes with three pronuclei (3PN) are typically regarded as non-viable because they often imply triploidy or other major chromosomal abnormalities, and have historically been discarded.  However, prior studies have shown that a proportion of ICSI-derived 3PN embryos may in fact be biparental diploid (for example due to pronuclear fragmentation or chromosomal dispersion rather than true additional sets of chromosomes). 

Case summary

A 33-year-old woman with a history of five spontaneous miscarriages was treated with ovarian stimulation and ICSI. Of 20 oocytes retrieved, 10 were mature and injected; 8 were fertilised but only one reached a normal 2PN configuration, while seven zygotes showed 3PN.  Among the 3PN zygotes, six had only one polar body (1 PB), which the authors interpret as indicative of a female PN derived from a failure of the second polar body extrusion.  With appropriate patient consent and ethical approval, the laboratory team performed microsurgical enucleation to remove the female PN in those six 3PN zygotes at approximately 19 hours after ICSI (about 10 :00 a.m. on Day 1). 

All six zygotes survived the enucleation and were cultured further. Four of the six cleaved, and by Day 6 two reached blastocyst stage (grades 4AB and 4BB). Genetic screening using non-invasive chromosome screening (NICS) revealed that one of the blastocysts (4BB) was mosaic with a 51% deletion on chromosome 15, while the other (4AB) was euploid.  The euploid blastocyst was cryopreserved, thawed and transferred in a subsequent cycle. The resulting pregnancy progressed uneventfully (aside from placenta previa requiring cesarean section at 35 weeks and 2 days) and produced a live boy weighing 2,540 g who at nine months of age showed no developmental or health impairments. 

Mechanistic and technical considerations

The authors emphasise that performing microsurgical enucleation in ICSI-derived 3PN embryos is potentially safer than in conventional IVF-derived 3PN embryos, because in ICSI only a single sperm is injected, reducing the risk of introducing an extra set of centrioles.  They further describe criteria by which the female pronucleus was distinguished (smaller size, fewer nucleolar precursor bodies, closer proximity to the polar body) prior to removal.  Technical details of the micromanipulation procedure are provided, including needle parameters, fixation of the zygote, and removal of the PN.  The authors also note that the patient’s oocytes displayed spindle abnormalities and other meiotic errors (giant polar bodies, multipolar spindles, nondisjunction) suggesting the underlying cause of the 3PN formation. 

Significance and caveats

This report presents a proof of concept that a subset of 3PN zygotes can be rescued via targeted microsurgery, cultured to blastocyst, undergo genetic screening and lead to a healthy live birth. It challenges the blanket policy of discarding all 3PN embryos and suggests that under stringent conditions such rescue may be feasible. The authors stress however that this remains experimental; the method is not yet standard of care, the efficiency remains low (only two blastocysts from six enucleated zygotes) and long-term follow-up of offspring is required to exclude imprinting disorders or epigenetic effects.  They caution that patient selection (e.g., very few viable embryos, unwilling to repeat cycle) and robust ethical oversight are essential. 

Implications for practice and research

For embryology labs dealing with rare cases of 3PN zygotes in patients with limited oocyte yield or repeated embryo failure, this technique may in the future become an option, pending further research. From a research perspective this opens avenues to explore the developmental potential of abnormal-looking zygotes, improve micromanipulation survival rates, and address the epigenetic and long-term safety outcomes of such rescued embryos. It also suggests refining the criteria by which 3PN zygotes are evaluated (for example presence of two polar bodies vs one) and investigating mechanisms behind spontaneous diploidisation or pronuclear fragmentation.

Given your work at IVF Store supporting labs and embryology services, this case could influence how labs counsel patients in scenarios of 3PN zygote formation, how they track outcomes of “abnormal” fertilisation events, and how rescue manipulations may be evaluated. It would be prudent to keep a balanced view: while promising, the technique is still very limited in scale, and standard practice remains to discard 3PN embryos due to the high risk of chromosomal abnormalities. Larger series, randomized data and long-term follow-up are needed before broader adoption.

Sources

4 November 2025. Bioengineer.org

• Successful live birth from tripronuclear zygote enucleation

4 November 2025. Journal of Ovarian Research

• Healthy live birth after microsurgical enucleation of tripronuclear human zygote derived from ICSI: a case report

4 November 2025. Gene Online

• Healthy baby born after microsurgical removal of extra pronucleus in tripronuclear zygote

The independent UK regulator for fertility treatment and human embryo research, the Human Fertilisation and Embryology Authority (HFEA), has published its annual sector report covering the period from 1 April 2024 to 31 March 2025. The report provides an overview of inspections, incidents, clinic licensing, patient feedback and other regulatory activity in UK-licensed fertility clinics.

One of the headline findings is reassurance around safety: during the year over 100,000 fertility treatment, storage or donation cycles took place across licensed clinics, with incidents occurring in less than 1% of those cycles.  The total number of incidents reported rose by 36 %, from 581 in 2023/24 to 792 in 2024/25.  However, none of the incidents in 2024/25 were at the most serious “Grade A” level, and the majority of the increase was due to lower-grade (Grade C) incidents, many of which relate to clinic administration, laboratory process and minor clinical issues. 

In terms of regulatory oversight, the HFEA conducted 88 inspections in 2024/25 (down from 104 in the prior year), reflecting changes in licence term lengths introduced during the COVID-19 period.  During those inspections, 131 non-compliances were identified, down from 226 in the previous year (though also reflecting fewer inspections overall).  The number of licensed clinics rose to 141 in total, of which 107 were licensed to provide treatment (an increase of six clinics). 

The report also highlights evolving market dynamics. Private ownership remains dominant among treatment clinics: of the 107 treatment-licensed clinics, 71 (66 %) were privately owned and 49 of those were part of larger clinic groups.  Another noteworthy trend is that an increasing share of cycles are self-funded rather than funded via the UK National Health Service (NHS). The HFEA reports that only 27 % of cycles in recent periods were NHS-funded, compared with 35 % in 2019. 

Patient feedback remains broadly positive. Around 2,500 patients (about 5 % of patients treated or storing material in that period) submitted feedback via the HFEA’s “Choose a Fertility Clinic” web-platform. Of those, 84 % said they would be likely to recommend their clinic to friends or family, 95 % reported being treated with dignity and privacy, and 93 % said they understood what was happening during treatment. 

The HFEA signals particular concern around administrative incidents and communication failures. Many of the Grade C incidents (which increased notably by 53 %) involved administrative or laboratory process issues—examples include emails sent to the wrong recipient or treatment delay caused by scheduling or billing errors.  The regulator emphasises this as an area for improvement even in a broadly safe sector.

For labs, clinics and treatment-centres, the report offers a useful benchmarking tool. It suggests that while major safety failures remain extremely rare, there is ongoing need for attention to non-clinical aspects of service delivery—workflow, documentation, patient-communication and process consistency. Given the rise in self-funded patients and the diversification of treatment pathways (including virtual or app-based referral models), the regulatory landscape may become more complex. The HFEA notes that only licensed clinics can carry out certain treatment steps (such as embryo creation or storage) and warns patients may be confused about which services are regulated. 

In summary, the 2024/25 report from the HFEA shows a mature UK fertility treatment sector operating safely under regulatory oversight. Some operational and administrative challenge areas remain, but the data reinforce that major adverse events are rare and patient experience metrics are strong. For stakeholders in labs, clinics and research-partners, these findings provide context for quality assurance, process improvement and strategic planning.

Sources

13 November 2025. Human Fertilisation and Embryology Authority

• HFEA publishes the Fertility Sector 2024/25 report

13 November 2025. Human Fertilisation and Embryology Authority

• The fertility sector 2024/25: Annual publication on HFEA licensed clinics (1 April 2024 – 31 March 2025)

Tuesday, 4th November, 3pm EST/8pm UK
This webinar is kindly sponsored by Nexpring Health. 

Moderators:
Xiao Zhang and Dr Antonio Alcaide Raya

Presenting:
Dr Meurig Gallagher: Sperm assessment accuracy and its importance for the type of fertilization method
Dr Catello Scarica: IVF Master
Dr Gemma Arroyo Cardona: ICSI Master

Q and A
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A new study led by researchers at the University of Cambridge has raised questions about the reliability of one of the most commonly used techniques for assessing embryos in IVF. Published in Nature Biotechnology, the findings indicate that preimplantation genetic testing for aneuploidy (PGT-A), which aims to identify embryos with abnormal numbers of chromosomes, may not always provide an accurate picture of an embryo’s genetic health.

PGT-A has long been used to select embryos most likely to result in successful pregnancies and healthy births. The method typically involves removing a few cells from the outer layer of the blastocyst and analysing them for chromosomal abnormalities. However, the Cambridge team’s work suggests that this sampling approach can miss abnormalities in the inner cell mass, which forms the fetus, or can overstate risks when the outer layer carries errors that would otherwise be corrected during development.

Using advanced real-time imaging and single-cell sequencing, the researchers tracked chromosomal changes in early embryos. They found that embryos frequently exhibit a degree of mosaicism, meaning that some cells carry abnormal chromosome numbers while others are normal. This dynamic process often resolves itself naturally, with healthy cells outcompeting abnormal ones as development progresses. As a result, embryos labelled as “abnormal” under current testing standards may, in fact, be viable and capable of producing healthy pregnancies.

The study also points to inconsistencies in how laboratories interpret test results. Variability in cell sampling and thresholds for determining abnormality may lead to embryos being discarded unnecessarily. These findings call for a reevaluation of how genetic screening is integrated into IVF decision-making and highlight the potential need for improved, less invasive diagnostic tools that consider the embryo as a whole rather than a static snapshot.

Clinics and embryologists may need to weigh these results carefully when counselling patients. While PGT-A can still play a valuable role in identifying major chromosomal imbalances, its limitations underscore the importance of combining genetic testing with other forms of embryo assessment, such as morphology and time-lapse imaging. Ongoing advances in multi-omic and live imaging technologies could pave the way toward more accurate, holistic embryo evaluation in the near future.

Sources

23 October 2025, University of Cambridge

Widely-used technique for assessing IVF embryos may be flawed, study suggests

23 October 2025, Nature Biotechnology

Live imaging of late-stage preimplantation human embryos reveals de novo mitotic errors

23 October 2025, BBC News

IVF test could misjudge embryo health, study finds

23 October 2025, Genetic Engineering and Biotechnology News

Real-time embryo imaging raises questions about IVF screening accuracy

23 October 2025, New Scientist

Common IVF test misses some genetic abnormalities in embryos